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Öğe Acute liver failure in adults(Aves, 2019) Caliskan, Ali Riza; Harputluoglu, Murat[Abstract Not Available]Öğe Analysis of risk factors affecting the development of peptic ulcer perforation: case-control study(Termedia Publishing House Ltd, 2021) Akbulut, Sami; Caliskan, Ali Riza; Saritas, Hasan; Demyati, Khaled; Bilgic, Yilmaz; Unsal, Selver; Koc, CemalettinAim: The aim of the to determine the risk factors associated with increased risk of peptic ulcer perforation (PUP). Material and methods: The demographic, clinic, and biochemical parameters of 65 patients (PUP group) who underwent PUP surgery at our clinic between June 2009 and September 2016 were compared with the data of 134 patients (control group) who underwent endoscopy at a gastroenterology clinic for dyspeptic complaints. The control group were matched at random in a 1 : 2 ratio with the PUP group. Univariate analyses were used to compare different variables and variables with clinical significance, and p <= 0.05 was used in the backward stepwise logistic regression model. Results: This study included 65 patients with peptic ulcer perforation aged 17 to 92 years (PUP group) and 134 patients with dyspeptic complaints aged 18 to 87 years (control group). Univariate analysis showed that statistically significant differences were found between groups in terms of non-steroidal anti-inflammatory drugs usage (p = 0.042; OR = 1.868), smoking (p < 0.001; OR = 5.124), old age (p = 0.003), low body mass index (BMI) (p < 0.001), and low hemoglobin (Hb) (p = 0.002). However multivariate analysis showed that increasing age (p = 0.004; OR = 1.035), smoking (p = 0.007; OR = 3.591), decreasing Hb (p = 0.042; OR = 1.277), and decreasing BMI (p < 0.001; OR = 1.669) were independent clinically significant risk factors for development of PUP. Conclusions: This study showed that decreased BMI, decreased Hb, increased age, and smoking were independent risk factors for development of PUP. Thus, this group of patients needs particular attention paid to suggestive symptoms with early diagnosis and optimal management of peptic ulcer disease.Öğe Effects of larazotide acetate, a tight junction regulator, on the liver and intestinal damage in acute liver failure in rats(Sage Publications Ltd, 2021) Caliskan, Ali Riza; Gul, Mehmet; Yilmaz, Ismet; Otlu, Baris; Uremis, Nuray; Uremis, Muhammed Mehdi; Kilicaslan, IlkayBackground and Aim The epithelial cells are the strongest determinants of the physical intestinal barrier. Tight junctions (TJs) hold the epithelial cells together and allow for selective paracellular permeability. Larazotide acetate (LA) is a synthetic octapeptide that reduces TJ permeability by blocking zonulin receptors. In this study, we aimed to investigate the effects of LA, a TJ regulator, on the liver and intestinal histology in the model of acute liver failure (ALF) in rats. Materials and Methods The thioacetamide (TAA) group received intraperitoneal (ip) injections of 300 mg/kg TAA for 3 days. The TAA+LA(dw) (drinking water) group received prophylactic 0.01 mg/mL LA orally for 7 days before the first dose of TAA. The LA(dw) group received 0.01 mg/mL LA orally. The TAA + LA(g) (gavage) group received prophylactic 0.01 mg/mL LA via oral gavage for 7 days before the first dose of TAA. The LA(g) group received 0.01 mg/mL LA via oral gavage. While liver tissue was evaluated only with light microscopy, intestinal samples were examined with light and electron microscopy. Results Serum ammonia, AST, and ALT levels in the TAA group were significantly higher than in control groups (all p < 0.01). Serum ALT levels in the TAA + LA(dw) group were significantly lower than in the TAA group (p < 0.05). However, serum ammonia and ALT levels did not differ between the TAA and other groups. Serious liver damage in the TAA group was accompanied by marked intestinal damage. There was no significant difference between the TAA and TAA + LA(dw) groups and TAA and TAA + LA(g) groups for liver damage scores. However, intestinal damage scores significantly decreased in the TAA + LA(dw) group compared to the TAA group. In the TAA + LA(dw) group, fusion occurred between the surface epithelial cells of neighboring villi and connecting regions formed as epithelial bridges between the villi. Conclusion Our findings suggest that LA reduced intestinal damage by acting on TJs in the TAA-induced ALF model in rats.Öğe Endoscopic treatment of biliary complications in donors after living donor liver transplantation in a high volume transplant center(Aves, 2020) Erdogan, Mehmet Ali; Cagin, Yasir Furkan; Atayan, Yahya; Bilgic, Yilmaz; Yildirim, Oguzhan; Caliskan, Ali Riza; Aladag, MuratBackground/Aims: Although living donor liver transplantation (LDLT) has been accepted as a primary treatment for adults with endstage liver disease, concerns about donor health have emerged. As LDLT is technically complex, it creates perioperative morbidity and mortality risk in donors. Biliary complications such as stricture and leakage are seen most frequently in donors after liver transplantation. While some of these complications get treated with a conservative approach, endoscopic, surgical, and percutaneous interventions may be required in some others. We aimed to present endoscopic retrograde cholangiopancreatography (ERCP) results in donors who developed biliary complications after LDLT. Materials and Methods: Between June 2010 and January 2018, a total of 1521 donors (1291 right lobe grafts, 230 left lobe grafts) who underwent LDLT were retrospectively reviewed. Sixty-three donors who underwent ERCP due to biliary complication were included in the study. Results: Biliary stricture was found in 1.6% (25/1521), biliary leakage in 2.1% (33/1521), and stricture and leakage together in 0.3% (5/1521) donors. Our endoscopic success rates in patients with biliary leakage, biliary stricture, and stricture and leakage were 85% (28/33), 92% (23/25), and 80% (4/5), respectively. Surgical treatment was performed on 12.6% (8/63) donors who failed ERCP. Conclusion: We found that ERCP is a successful treatment for post-LDLT donors who have biliary complications.Öğe Evaluation of stent applications for upper gastrointestinal disorders(2024) Caliskan, Ali Riza; Yildirim, OguzhanAim: Gastrointestinal stents are predominantly used for palliating malignant dysphagia in patients with esophageal cancer when surgical intervention is deemed inappropriate. This research aims to elucidate the diagnostic and follow-up processes of patients who underwent stent placement for upper gastrointestinal system pathologies at our clinic. Materials and Methods: A retrospective analysis assessed 61 patients who received stents for upper gastrointestinal tract stenosis due to various causes. Patient demographics, including age and gender, underlying pathology, benign-malignant status, location of the pathology, prior surgical or bougie dilation interventions, post-stent survival status, and, if applicable, the duration between the procedure and decease, were evaluated. Patient health records were accessed from the hospital’s electronic medical database. Results: Pre-stent bougie dilation was performed in 26.2% (n=16) of patients, while pre-stent surgery was undertaken in 41% (n=25). Repeat stenting was necessitated in 6.6% (n=4) of cases. Of the patients, 86.9% (n=53) succumbed to their condition, while 13.1% (n=8) survived. Post-stent survival times for deceased patients after stent surgery ranged from 0 to 55 months, with a median survival time of two months. Surviving patients exhibited varied post-stent durations between 65 and 122 months, with a mean stent utilization period of 101 months. A statistically significant correlation was observed between pre-stent surgery and survival status, indicating a higher surgery rate in patients who survived than those who did not (p<0.05). Conclusion: Consequently, due to its cost-effectiveness, stents can be a viable alternative to surgery for both benign and malignant gastrointestinal disorders. This is attributed to its notable advantages, including flexibility and high resistance.Öğe Fingolimod induced fulminant liver failure requiring liver transplantation: A case report(Kare Publ, 2023) Caliskan, Ali Riza; Harputluoglu, Muhsin Murat Muhip; Samdanci, Emine; Cirik, Salih; Yilmaz, SezaiFingolimod has been used for about ten years to treat multiple recurrent sclerosis. It has been reported that Fingolimod causes an elevation in liver enzymes. In this case report, the clinical and laboratory parameters improved after discontinuation of the drug. However, there is no publication in the literature regarding acute liver failure and liver transplantation following Fingolimod treatment. In this article, we presented a 33 - year - old female patient who developed acute liver failure and underwent liver transplantation after Fingolimod treatment for recurrent multiple sclerosis.Öğe Gastrointestinal amyloidosis occurring in three different patterns: Case serie(2019) Cagin, Yasir Furkan; Caliskan, Ali Riza; Bilgic, Yilmaz; Yildirim, Oguzhan; Erdogan, Mehmet Ali; Seckin, Yuksel; Alan, Saadet; Karadag Soylu, NeseSystemic amyloidosis is a rare disease characterized by extracellular accumulation of amyloid protein in one or more organs. In patients with systemic amyloidosis, the most frequently affected organs are kidney and heart, followed by the nervous system, soft tissues, and lungs. Small bowel and liver involvement are also frequent in systemic amyloidosis. Gastrointestinal (GI) findings are common, and the degree of organ involvement determines the symptoms. Patients usually have nonspecific findings such as abdominal pain, nausea, diarrhea, and dysphagia, which may delay the appropriate diagnosis. Liver involvement occurs in the majority of patients, but the symptoms typically do not happen unless a marked hepatic amyloid deposition occurs. Diagnosis is by tissue biopsy. Treatment and prognosis depend on the underlying disease. GI system involvement is a sign of poor prognosis. In this case series, five patients who were diagnosed with gastrointestinal system amyloidosis in our clinic are presented.Öğe Larazotide acetate reduces the frequency of bacterial translocation in the thioacetamide-induced liver failure in rats(Elsevier, 2020) Caliskan, Ali Riza; Harputluoglu, Muhsin Murat; Otlu, Baris; Gul, Mehmet; Ozerol, Elif; Uremis, Nuray; Dertli, Ramazan[Abstract Not Available]Öğe Ornidazole-Induced Liver Injury: The Clinical Characterization of a Rare Adverse Reaction and Its Implications from a Multicenter Study(Mdpi, 2025) Caliskan, Ali Riza; Turan, Ilker; Vatansever, Sezgin; Weninger, Jasmin; Samdanci, Emine Turkmen; Akatli, Ayse Nur; Isik, ElvanBackground and Aims: Ornidazole, a nitroimidazole antibiotic, is widely used for protozoal and anaerobic infections and is generally considered safe. However, ornidazole-induced liver injury (OILI) is an underrecognized yet potentially severe adverse reaction. This multicenter study aims to characterize the clinical features, histopathology, and outcomes of OILI to improve the awareness and management of this rare entity worldwide. Methods: We conducted a retrospective analysis of 101 patients with OILI from eight tertiary centers between 2006 and 2023. Cases were included based on liver enzyme elevations temporally linked to ornidazole and the exclusion of other causes. Causality was assessed using the Roussel Uclaf Causality Assessment Method (RUCAM) score. Clinical data, laboratory parameters, autoantibody profiles, histology, treatments, and outcomes were evaluated. Results: OILI was classified as highly probable in 42.6% of cases (n = 43), probable in 51.5% of cases (n = 52), and possible in 5.9% (n = 6) of cases. The predominant pattern was acute hepatocellular injury (83.2%) (n = 84). Autoimmune-like hepatitis occurred in 5% of cases (n = 5), with ANA positivity in 16.8% of cases (n = 17). Corticosteroids were used in 24.8% of cases (n = 25) and were associated with higher ANA positivity and a 20% (n = 5) relapse rate post-discontinuation. Recovery was achieved in 87.7% of cases (n = 88), while 7.9% of cases (n = 8) required liver transplantation and 4% (n = 4) died. Conclusions: Ornidazole can cause serious idiosyncratic liver injury, including autoimmune phenotypes, and should be considered in the differential diagnosis of acute hepatitis. Given the notable risk of liver failure and death, early recognition, drug discontinuation, and close monitoring are essential. In select cases, corticosteroids and plasmapheresis may be beneficial, though the evidence remains limited.Öğe Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study(Lippincott Williams & Wilkins, 2021) Efe, Cumali; Dhanasekaran, Renumathy; Lammert, Craig; Ebik, Berat; Higuera-de la Tijera, Fatima; Aloman, Costica; Caliskan, Ali RizaBackground and Aims Data regarding outcome of COVID-19 in patients with autoimmune hepatitis (AIH) are lacking. Approach and Results We performed a retrospective study on patients with AIH and COVID-19 from 34 centers in Europe and the Americas. We analyzed factors associated with severe COVID-19 outcomes, defined as the need for mechanical ventilation, intensive care admission, and/or death. The outcomes of patients with AIH were compared to a propensity score-matched cohort of patients without AIH but with chronic liver diseases (CLD) and COVID-19. The frequency and clinical significance of new-onset liver injury (alanine aminotransferase > 2 x the upper limit of normal) during COVID-19 was also evaluated. We included 110 patients with AIH (80% female) with a median age of 49 (range, 18-85) years at COVID-19 diagnosis. New-onset liver injury was observed in 37.1% (33/89) of the patients. Use of antivirals was associated with liver injury (P = 0.041; OR, 3.36; 95% CI, 1.05-10.78), while continued immunosuppression during COVID-19 was associated with a lower rate of liver injury (P = 0.009; OR, 0.26; 95% CI, 0.09-0.71). The rates of severe COVID-19 (15.5% versus 20.2%, P = 0.231) and all-cause mortality (10% versus 11.5%, P = 0.852) were not different between AIH and non-AIH CLD. Cirrhosis was an independent predictor of severe COVID-19 in patients with AIH (P < 0.001; OR, 17.46; 95% CI, 4.22-72.13). Continuation of immunosuppression or presence of liver injury during COVID-19 was not associated with severe COVID-19. Conclusions This international, multicenter study reveals that patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD. Cirrhosis was the strongest predictor for severe COVID-19 in patients with AIH. Maintenance of immunosuppression during COVID-19 was not associated with increased risk for severe COVID-19 but did lower the risk for new-onset liver injury during COVID-19.Öğe Protective Effect of Canaboid Type 2 Receptor Agonist (JWH-133) Against Hepatic Endoplasmic Reticulum Stress Induced by Prangos Ferulacea Extract(Wiley, 2022) Celik, Mesut; Duzova, Halil; Karaca, Zeynal Mete; Tasidere, Asli Cetin; Gecibesler, Ibrahim Halil; Caliskan, Ali Riza[Abstract Not Available]Öğe A STUDY OF ACUTE LIVER INJURY ASSOCIATED WITH ORNIDAZOLE: ANALYSIS OF 82 CASES IN TURKIYE(Lippincott Williams & Wilkins, 2023) Turan, Ilker; Durmazer, Esra Nur Nur; Vatansever, Sezgin; Caliskan, Ali Riza; Harputluoglu, Murat; Efe, Cumali; Idilman, Ramazan[Abstract Not Available]Öğe Successful treatment of aggressive AA amyloidosis with tocilizumab in a patient with polymyalgia rheumatica(Oxford Univ Press, 2024) Atas, Nuh; Caliskan, Ali Riza; Akatli, AysenurPolymyalgia rheumatic (PMR) associated amyloidosis is an extremely rare condition that can be rapidly progressive with high morbidity and mortality and management is challenging. Tocilizumab is a monoclonal anti-IL-6 receptor antibody, which is in the therapeutic arsenal of PMR. The efficiency of tocilizumab in improvement of PMR activity score and decreasing steroid dose is well-established, while efficiency in PMR-associated amyloidosis has not been published. Herein, we reported a PMR patient with amyloid A amyloidosis who was treated effectively with tocilizumab.
